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Solid Cancers

Prognostic impact of progression to induction chemotherapy and prior paclitaxel therapy in patients with germ cell tumors receiving salvage high-dose chemotherapy in the last 10 years: a study of the European Society for Blood and Marrow Transplantation Solid Tumors Working Party

Bone Marrow Transplantation volume 51, pages 384–390 (2016)Cite this article

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Abstract

Little is known about the prognostic impact of prior paclitaxel therapy and response to induction chemotherapy defined as the regimen preceding high-dose chemotherapy (HDCT) for the salvage therapy of advanced germ cell tumors. Twenty European Society for Blood and Marrow Transplantation centers contributed data on patients treated between 2002 and 2012. Paclitaxel used in either prior lines of therapy or in induction-mobilization regimens was considered. Multivariable Cox analyses of prespecified factors were undertaken on PFS and overall survival (OS). As of October 2013, data for 324 patients had been contributed to this study. One hundred and ninety-two patients (59.3%) had received paclitaxel. Sixty-one patients (19%) had a progression to induction chemotherapy, 234 (72%) a response (29 (9%) missing or granulocyte colony-stimulating factor without chemotherapy). Both progression to induction chemotherapy and prior paclitaxel were significantly associated with shorter OS univariably (P<0.001 and P=0.032). On multivariable analysis from the model with fully available data (N=216) progression to induction was significantly prognostic for PFS and OS (P=0.003), but prior paclitaxel was not (P=0.674 and P=0.739). These results were confirmed after multiple imputation of missing data. Progression to induction chemotherapy could be demonstrated as an independent prognostic factor, in contrast to prior paclitaxel.

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Authors and Affiliations

  1. Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy

    A Necchi, R Miceli, D Raggi & P Giannatempo

  2. Medical Oncology, Azienda Ospedaliera di Busto Arsizio, Busto Arsizio, Italy,

    M Bregni

  3. Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany

    C Bokemeyer, L A Berger & K Oechsle

  4. UKGM-Marburg Klinik for Hematology and Oncology, Marburg, Germany

    K Schumacher

  5. Imperial College, Hammersmith Hospital, London, UK

    E Kanfer

  6. Gustave Roussy, Institut de cancérologie, Villejuif, France

    J H Bourhis & C Massard

  7. European Institute of Oncology, Milano, Italy

    D Laszlo & J Montoro

  8. Centre Léon Bérard, Lyon, France

    A Flechon

  9. Gulhane Military Medical Academy, Ankara, Turkey

    F Arpaci

  10. Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    S Secondino & P Pedrazzoli

  11. Universitätsklinikum Heidelberg, Heidelberg, Germany

    P Wuchter & P Dreger

  12. University Hospital of Aachen, Aachen, Germany

    M Crysandt

  13. University of Vienna, Vienna, Austria

    N Worel

  14. Universitätsmedizin, Greifswal, Germany

    W Kruger

  15. Klinikum Karlsruhe gGmbH, Karlsruhe, Germany

    M Ringhoffer

  16. Kapadokya BMT Center, Kayseri, Turkey

    A Unal

  17. Chaim Sheba Medical Center, Tel-Hashomer, Israel

    A Nagler

  18. Instituto Português de Oncologia do Porto, Porto, Portugal

    A Campos

  19. Umea University Hospital, Umeå, Sweden

    A Wahlin

  20. Centro di Riferimento Oncologico, Aviano, Italy

    M Michieli

  21. Gazi University of Medicine, Ankara, Turkey

    G Sucak

  22. University Hospital of Careggi, Firenze, Italy

    I Donnini

  23. Universitair Ziekenhuis, Brussel, Belgium

    R Schots

  24. Centre Hospitalier Universitaire (CHU), Angers, France

    N Ifrah

  25. EBMT Study Office, EBMT, Paris, France

    M Badoglio

  26. Azienda Ospedaliera BMM, Reggio Calabria, Italy

    M Martino

  27. Ospedale Ca’ Foncello, Treviso, Italy

    G Rosti

  28. Istituti Ospitalieri di Cremona, Cremona, Italy

    F Lanza

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  1. A Necchi
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  2. R Miceli
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  4. C Bokemeyer
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  7. K Schumacher
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  8. E Kanfer
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  15. S Secondino
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  16. P Wuchter
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  17. P Dreger
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  18. M Crysandt
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  19. N Worel
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  20. W Kruger
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  21. M Ringhoffer
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  22. A Unal
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  23. A Nagler
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  24. A Campos
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  25. A Wahlin
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  26. M Michieli
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  27. G Sucak
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  28. I Donnini
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  29. R Schots
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  30. N Ifrah
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  31. M Badoglio
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  32. M Martino
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  33. D Raggi
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  34. P Giannatempo
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  35. G Rosti
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  36. P Pedrazzoli
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on behalf of the EBMT Solid Tumors Working Party

Corresponding author

Correspondence to A Necchi.

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The authors declare no conflict of interest.

Additional information

Presented in oral session, Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT), Istanbul, Turkey, 23−25 March 2015. Presented in poster session, Annual Meeting of the American Society of Clinical Oncology (ASCO), Chicago, IL, USA, 29 May−2 June 2015.

Supplementary Information accompanies this paper on Bone Marrow Transplantation website

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Necchi, A., Miceli, R., Bregni, M. et al. Prognostic impact of progression to induction chemotherapy and prior paclitaxel therapy in patients with germ cell tumors receiving salvage high-dose chemotherapy in the last 10 years: a study of the European Society for Blood and Marrow Transplantation Solid Tumors Working Party. Bone Marrow Transplant 51, 384–390 (2016). https://doi.org/10.1038/bmt.2015.300

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